WI0400485_DEEMED FILES_20180731

North Carolina Department of Environmental Quality-Division of Water Resources
INJECTION EVENT RECORD (IER)
Permit Number WI0400485
1. Permit Information
Cintas Corporation
Permittee
Fonner Rental Towel and Uniform Services Site
Facility Name
610 Woody Drive, Graham, Alamance County, NC
Facility Address (include County)
2. Injection Contractor Information
AECOM
Injection Contractor/ Company Name
Street Address 1600 Perimeter Park Drive Ste 400
Morrisville NC 27560
Were any wells abandoned during this injection
event?
D Yes IZI No
If yes, please provide the following information:
Number of Monitoring Wells _____ _
Number of Injection Wells. _______ _
Please include a copy of the GW-30 for each well
abandoned.
4. Injectant Information
EDS-ER®, sodium bicarbonate, Nutrimens ® Solution
Injectant(s) Type (can use separate additional sheets
if necessary
City State Zip C'OOlEJ~ Concentration 0.81lb/gal EDS-ER®. 0.3 lb/gal
0/Ncl>t:h, sodium bicarbonate. 0.002 gal/gal Nutrimens®
r-,v4)~ [phone]
Area code -Phone number JUr ·11 I~ th~ inject_ant is d~luted please indicate the source
'20l ~ d1lut1on flmd: Offs1te Source
3. Well Information
Number of wells used for injection
Well IDs EW-6
ftflf11,,.~ Water
"""IIIO~lty
1 Seci1tit:
Were any new wells installed during this injection
event?
!ZI Yes D No
If yes, please provide the following information:
Number of Monitoring Wells _ ___,3'-------'
Number of Injection Wells __ ___,O'---------'
Type of Well Installed (Check applicable type):
D Bored IZI Drilled D Direct-Push
D Hand-Augured D Other(specify) __ _
Please include a copy oftlte GW-1 fo rm/or each
well installed.
Total Volume Injected (gal): 2,750
Volume Injected per well (gal): 2.750
5. Injection History
Injection date(s): June 11 -15 . 2018
Injection number (e.g. 3 of5) _~l'-'o"-'f'-'1,__ __ __.,
Is this the last injection at this site?
D Yes IZI No
I DO HEREBY CERTIFY THAT ALL THE
INFORMATION ON THIS FORM IS CORRECT TO
THE BEST OF MY KNOWLEDGE AND THAT THE
INJECTION WAS PERFORMED WITHIN THE
STANDARDS LAID OUT IN THE PERMIT.
S~TION CONTRACTOR +/¾(J'{
Amanda Gonzalez and Ashbourne Whichard
PRINT NAME OF PERSON PERFORMING THE INJECTION
Submit the original of this form to the Division of Water Resources within 30 days of injection.
Attn: UIC Program, 1636 Mail Service Center, Raleigh, NC 27699-1636, Phone No. 919-807-6464
Form UIC-IER
Rev. 3-1-2016
WELL CONSTRUCTION RECORD
Tier form car be lad For sinelo or Radii* %stir
Far 'karma Use ON2.1':
1. Wd1 Contractor Information:
Rich Leomira
Writ Contractor Name
2593A
NC Weil Con rxtar Ccrtifi:alion Number
SAR ACCO Inc
Comma, Nana
2. WdI Conatrartinn Permit 0:
Lie WIappliirsbf rod. rperreffr f1..`. Crivlirn'_ Samar, Voriul!lr.Irri01 1
3. WdI Foe ((heck well ■:e):
Water Supply Wells:
DAgtiiculturat
DGeolhermal Muting/Cooling Supply)
rl induslrialtCommercial
RlnnLuRoo
Nog -Waver Supply Well:
1I1M nitor'tni'
LiAiti iicipa1,'F'uibli;
[1Resideniial Water Supply (single)
°Residential Wmer Supply (stxiredl
❑Reetr%rn
lIjedttan R'eil;
DAquifcr Recharge
RAtprircr S1oragc and Rprn%e:y
RAquifer Tat
DExperirncnial Technolau
❑Geodiemail tClased Loop)
LIG oliierrwal
Reiwii
°Groundw'ater RcrlrcdiMion
ElSalinit}- Barrier
CSior1m511tcr Drainage
❑Srftsidcraoe Control
❑Tracer
} EIOtber te!rpiaiI miler 021 Relluid.sL
4. Date Waft) Completed: 6-7 -2028
Lot/taintSm. Wd1 Lot/taint
1: cilit7O nerNorm
610 Woody Dr Graham, NC 27253
GRAHAM, NC, 27253
ALAMANCE
Well l IDtt PMW- 3
FnCt3 I Mg of apptiraibk5
Alamance County 36.0,
Pinned Addian. Cif. and Zip
(-mom! P rLrl l�uhfrCirinn T�lu 1Plti}
i.Rtitside and 1.anilitaadc in ikitrrr•iclminrtrn/l;cronds nr *timid*timiddrgmes:
rif„fa0ld.weeku•lurkrKzudreirar
36.058637 7 79.38532
6.11 taro the welltrk n'enalainent or JTemporary
W
7. Is thitsi a reptirto air existing well; OYesi or &No
f/ Ihis of n repalr, fitf a� it brawn yard i 01.0 rr ki moo ailfonmaiari stroll vSyitnfli rl'r r41r►rrt o f VAr
rrirairunder 4.:l remarks raaimrr or conrlir hw'P this form.
8. Number of wells ibis irnrttt 1
Fur mi.taipir Jr:f rvo r! .a rom-.Airer slil+r It err fh ONLY hVrh rim moor nrnAlricarinn suer .ray
aybimi mir /hrwi.
9. Total ell depth beim§ land ► reface: 31 _ _ _ _(rt.)
a, Far mrirlplr rfrs ti1r RNsierkr if�rrAnr (wimple AtIalr surf 2tf tP0
10. Static water level below hop of raaring 12'
1{M'diry low( 15 dA'pii tYaps. the "i"
Bnrrbnlr diameter. 6 w Oa.)
ILWvII cotmtr%ctioo method: AO•GHR/AIR
Mary,
Ile. auger, a y, Calhlc, ducat push rac.)
i(A.)
FOR WATER SUPPLY WELLS ONLY;
I3a, Yield (gran) Method of test:
13b. DisinfectDisinfectantt1ge Amount:
11.1 t1lkZONIS
vows TO plrat'atr114'1
n. n,
n.
n
1'i1t 15.OR CASING Oar a oRinorld aid >`Olt LiifL7ltN w$r18kl
1Ro1K Ta or a?rrrTsrt rilt[i. S85 MA]ERIAk
n. hl Is.
li. INNER C_AMNG OR TERING F
FROM TO DL4 U TER
O R. 11' R. �2"
11.
_
17 SCRUM
moil • TY
11' R.
31' R.
nIAMv1RR
2"
IL
SM.aT l.97F • T1RICla!U' . i MATERMATERIAL
.010 SCH4O PVC
n.
i1.
far.
1
mm
n
0
ft,
TO
7' 11.
MATERIAL. (MPLACEME'4T /ME11i0O t AMOUNT
PORTLAND , POURED
ft.
na
1t.11101.ri.11i0U ifs fit re hnuel
n om 5tr MATERIAL
9' A. 31' IL SAND
RMINACTOr r MKilon
#2
n.
R.
111. DR1WKG LOGE aldNehiirl w deco§ Irraeren 1
IMO%I
O 11,
e ' n.
TO
8' n.
23' tL
CLAY/SILT
P1WR
fa
der. der. ar bra. opW nrfa r gram vier. MO
23'
31' n,
ROCK
R.
06
1,
IL
A.
1tr
Z1 BEMARKS
BENTONITE FROM 7' TO 9' -
22. Certification:Certification:SSgfrltrn cTCeni JYsil Coll 1 cwr
6/9/2019
Dale
ow'M
.8i signirif' caw fora, 1 krrrhr arrrrifi :ha 11ar Hr'lil 1. I* As 047,0 rruraslm•nrd in rrriibra MICE
With 154 NC C.,12C ,PIGY) or r SA ,1ICAC 0;C' ,020Ctinsrrwi 17 Well lien SuI1 irdi aid Aar a
eoryofrAilword rirtnTheoproi'idivla.oar'arilrr'mown
13, Site diagram or additional well dtlallit:
You may use the -boa-boaof this page to provide additional well site details or well
constmetion details. You may also ;Mach additional pages if necessary.
18M 1TTA 1 1 NST11t'TlON
21a. For Ail Welk: Subrrrit dais fame within 10 Ares of compidion of reed
rnrrsinrctivn In lase To Hon ing-
birisinn of Water Rtranreer, Information Processing Unit.
1617 Mil. Service [:cater, Raleigh. NC 27699-1617
21b. j''or_lrnierdoe Well§ ONLY: in addition to sending the form to the address in
24a above. also submit a cop of this forth w ithin 50 days of completion of Nt11
constnieiion to tie follorauag.
Dh'islti8 or Water RerI. Ulddergro nd injrttios Control Program.
1636111al1 Service Center. Raleigh. NC 27699.1636
21c.. For Writer Smell]) & injection Welly:
Also submit one copy of this form within 311 days of completion of
hell consinaction to the coral• health deparlmrart of the calm where
camarticicd
Form GH'-1
Nash Cambia D.To tnirso of Emironrta slid Nana(Rrsmuaes - Uii Bloc of Wort Rnoti lac. red August 9411

WELL CONSTRUCTION RECORD
nit farm can be usad far dog%or rnakipla watts
1. Weil Centricturirdermrtloa:
Rich Lemire
WWII Carxractvr Name
25 93A
WWI ComrserorCertification Number
SARDACCd Inc
Compi ry Name
2. Wall Coupe redo& Persidt at: _
Uri glloppti[ri it w.fl primfrr (L . rain •. Soar, Liirimrr, lefirtirg r1r.1
3. Well life (cheek well use):
Water Supply Weil:
MAgricullurat
C]Oeolhemlitl (Heatingtooiing Soppy)
Dindust iabComirrercial
kip.' ion
rIMnnicipal/Public
DResidelnimi Water Supply (single)
RResidential Water Supply (sly tad)
Noll -Water Supply Wen:
teMonrtorin -
Inject -ma ►►eel:
DAquifcrRech.trge
0Ag01fcrStolage and Reco vly
OAquifcr Test
13Expemncncil Tiaclmvla,'
IlOecilterinal (Closed Loop)
DGblltikrtiLll :i:,:OEirtH . rt,lrrit Rotuma
4.Date WWII01Completed: 6-7-2018
5a. WdI Lleatiun:
CINTAS
Flcilil lOworrNartre
OGroi ndeatcr Rorrlodtnnon
OSslirtin• i3arricr
L7Storwrwatcr Drainage
QSn6Adcrrcc Cor1n,
tp3 racer
OOd14`r (rnpli.in under 821 Remarks)
Welt IDI PMW-2
F• :f1il • Mk (if applictilrlo)
610 Woody Dr Graham, KC 27253 Alamance County 35.0.
GRAHAM, NC, 27253
ALAMANCE
PkLir-al Address Cr3-_And Zip
OHM! Pbrctl t&rgif.Ctlior h N . totN)
ilr, Latitude and Longitude in degrees/minettaisrcondr or decimal *rem
Woolf wolf nerd. orie LT47o1g 0341600
36.058637 N 79.38532
6. h bird the*edits): et/Permanent or fTtmpor:ary
W
7.Istint arepair icasWsiatiagwdlt OW* or 22Nu
?flair it a repegr, fil errrbromt Loll eonoruMoo i.lfor n:Woo rmd raniabt th. rwriire of the
repair one:ern; retnur/a arri,mu or en the ODAA of rhlr fvrut.
S. Number of wells co ad rooted: 1
For msldpie irtjecrkrn er +r90.101 aner a+q.pFr walls ONLY MO i r raw erourraidre, your aea
subwrikar r form,
9. Told well depth below load surface: 31'
For maniple r+eihlijra?lderth7lldlll+er+rtr[rxaryrfr-34,20ir4rarl le on
Static watts level below no of clriuv 12 (0.)
t/hwerr k'vrl it &brave eeiur, we +"
11.1Bprch k diameter: 6 '
010
12. Well constrncl1on toothed: AUGER/AIR
auger. /rimy, habit duvet prs1Lt$ .)
�•)
FOR WATER SUPPLY WILLS ONLY:
13a. Y.nId (011:1) Method of teat:
13b. Disinfection type: Amoont:
Fuflllcuml Use ONLY:
14, Walk ZONNIS
rrom
TD
ta1SCRlrnlOrl
R.
11.
h.
tt.
15.0LITKI i CASING (lie inuikaoed marl tl! L 'I±.R of applicabILI
TirOM
TO
rlrAMLTER T1drCENESS
MATERIAL
It.
IL.
Is.
la Mtat*
Outlet. OR fl'IilNG
liermdclosed-imiei
VkOM
7ii
it THICKNIS5
MATERIAL
0 R.
11' 11.
7' A,
SC840
PVC
19,
w 11.
itSCIELA
`T-Tln(7tlerat
MOMt
TO
avoirerr.R
M,0TSim
tMA77r11rat.
11' R.
31' IL.
2' I.
.010 SCH40
PVC
I1t.
R.
ts.
illo>tf
TO
MATERIAL _ EMPIAL-EinviT oz19ao s AMourir
r0 It.
7' n.
PORTLAHD POURED
k
f. tt.
EL SAN neatAVIIILPACK
tit rola- lm
Mat
lu
1ara , IlIAt,
lhot.orrasikr'lAr:telga
9' fr.
31' Ir,
SAttb
#2
ft.
a.
IRa. J7tc
Can iamb
.addltised.plods N return i
_kit
MOM
iu
w'icirrni y t#1r.9ir/NFM. r.WneI, op.. pia dm. e1g-
0 h.
9' n,
Ct. T/Si:yr
8' 1t.
23' D.
PIIR
23' tl.
31' tr.
Roes
1t.
R4
f1.
d. ~
h.
0.
a.
et.
t It 0LMA><iICR
' Dumbe ITR PROM 7' TO 9' .
I
21. Cer ificatlna:
..f
Si�Lere ofCcnsl{+1W1fd1 Castsmclnr
6/9/2018
Dais
!f� aigating rbi+ichms 1 krrrby .r01 shwa rlu wrIO Lux (itrnrl ebrlrtr.r.tod ire rrr.+awrordoxv
NM 1544 NCAC OZC .0IA9 or ISA NCAC 02C ,0200 stew Crrrrafrrrrrrwr 5rarrfar irdane(dwr
ivy of Mil rrcnrrl has' Arm pmiii* f rn ohs aKlt mrnrr,
23.Site din:root or soiliti sul well detain:
You may uss the bock of this page to provide additional well site details or well
construction details. You inay also attach additional pages if necessary.
R13RMITTA1:INST1 CTIONS
34a. For All Welts: Submit this fouls within 10 daps; of c iipkliot of via
canstmetiorr lv lhz falioning;
Division of Water Resources. Itchorwtation Prate:4k: Unit,
1617 Irma Sen4rc Ccatrr, Rxlekgh, NC 27699-16 t7
24b. For int IIoi Wejlj ONLY: Ir1 addition to sending the form to the address in
24a above. also submit I1 copy of this form ttlthin 3E) days of completion of well
construction ter the following:
Division of Water Resources. Uader'Iround I8jecriob Control Program,
1636 Mail Service Center, Ratel:11.NC 17699.1636
Z4c, For Water Salmi% 1k iniectipw Wells:
Also submit one copy of this form s►iihin 30 days of completion of
«ell ceusinrct9on to the comity health depwnnrct9 of the county where
constructed.
Form OW- l
Nord Carolina Dapanz rnl of E&Vtrorcurw aid Mantra] Rcsamoes -1aitits tan of W9lcr Rrsorrem Re+tsrd August 2011

WELL CONSTRUCTION RECORD
Ths forincan to mod for SiiVk or radii* walls
1. Well Connector Information:
Rich Lsmire
11'efi Combiner Warm
2593A
NCWci1 Contractor Ccnifrcbiian NNrjci
SAZDACCO Inc
Covet) Hann
Z Wdl Const motion Permit il:
1'�rr u!l npplirra6lr leea prowl)+ f l.r, frurnn. ,Skrm Variance, Averting sir
3. WdI Use {check wdl am):
Wider Supply Well:
❑Agricultural
°Geothermal lHeaiineCooling Supply)
I3lndustrial/Commerci al
❑ iniurpon
i7MunicipalrPuhlic
❑ Residential %rater Supply IsingJe)
❑Residential Water Stipp!) (sharedI
tio.•Water Supply Wtii:
lllMoniiorin.
ORck ntr.
Injection Well:
C1 Aquifer Recharge
❑ Aquifer Stowe nisi Recovery
ra Aquifer Test
❑ Experimental Technulogi.
❑ Grrodiermul (Closed Loop)
❑GeatIItm1rl IHcanrleCoolinr Return)
4. bate WeIt{tl Completed: 6 - 7 =2 a 18
Ss. Wdl Location:
CINTAS
F.ctlk CT. Now
610 Woody Dr Graham, NC 27253
GRAHAM, NC, 27253
ALAMANCE
Conan
OQroundstater RcmediaMioat
❑ Salinity• Barrier
t3Storrnfa1tcr Drainage
138tihsiclencc Control
f77raser
DOt hu !color raider #21 Retnuds)
IWdImot PMW-1
F.cili) IDk ttf apphenbtal
Alamance County 36-0,
Pit, sic1J Additss. CA*. and Zip
t'dnnd Id,;rqurcC,71>pn Nci Ir1Ni
9h. )altitude and Longitude in degrres/mintticx/reronds or riceimal degrees:
Itfwen ilea one 1atdotis is milkierul
36.058637 ii 79.38532
6. ie1 fame) the well).): 21Prrminent or °Temporary
7. Irl tbis a repair co as existing well: ❑Vier nr 03INii
//iif6 it o t re& ja11.Aot ARr,I{N welt eneen,t ro nv I+tlu 5urrrion oral r trio/di Ow +wa re ,+f tr
r r1.rir cordrr 101 remarks Arcata. or al ehr Iron of fR+x form..
8. Number or wells con:detacted: 1
for metitrf41 01,fecWori t nrarwow riq+)+!+ Falls DA'1.Ye9rA the ranee.rairsfrarrllw+r. ww •ON
:Moir nue land.
9. Total troll depth brlo+i laid [arroc'r„ 31'
{UrAsYkiplr Filar lrtrr+Vdrpnr*s tftirere'+{r trriuripre, 20.*171I',srid 2./00)
Ill. Static wafter level below hip of ensiugr 12'
1/weirs let rl U ohow utak*. rx "s
11. Basreink diameter: 6'
Ova
12. Well construction method: AudsR/Ara
Ile. auger. ream. cubic direct pusk etc.}
Far Trend Use ONLY:
14. %YAt'tic reett.
F'aOM
Tao
Urti['AtP110
h.
ft.
ft. If.
J5.o`[,CASIAAC time mulkimAtteusi Oft LINER tlf appliroblet
FROM TO 1 DIAMETEI _ T3111-kr1i55 MA1TAL4L
ft. rt.
GOR11117NG dcI f041'
pc► IfETEK THICKNESS
PROM j 7v MAMMAL,
O ft. 11' It. I2• Il SCH40
ft. R.
PVC
1nOW i 70
11' h.
31' Is.
ountaTFa
2`
iv.
8T0T 517F
.010
THriCisems
SCRQO
MATRrt1A1.
PVC
h.
f6
10 GItl)Rrf
FROM
O ft.
TO J 1MATERNU. 1 VOIACTOWITAirmoU R AMOV IT
7ft. i PORTLAND ; POURED
It. 1.
rt. rt.
SANDIGN AV 079 ittakt
FrOtt 70 MATIIkIU. tlltlt ¢'C kVrmotion
9' ft. 31' 11.
p. h.
SAND
12
1M. DRILLING LOG Iauari a liVimm1A sYrets le
FROM
TO
or1sltrrTrox [...Ur. row..... 2. r.el ftE+- greet we. w,. r
0
fL
8'
ft
CLAY/SILT
8'
h.
23'
ft.
PiaR
23'
- 31'
ft.
ROCK
h.
ft.
1'1.
ft.
B. =MARKS
fa.
0.
9ZNTONITE FROM 7' TO 9'.
L
22. Certdtc.Iiita:
Si�nti.ae afCcnif7Yell Carsiactar
6/9/2018
Date' -
nt aigninr iliir form. 1 M r1i errjlfr raid Fir trrllfrl 1rro.t barrel rururru.red in omprziaricr
with f M MCA(' 02C ,OFIYI or 154 74CAC 1.7:C ,9200 Wrl/ CrmSfrNrnrw Srandued6.rnd Aim,)
d n of Mir rrrnrriArr,+ rem pm:1AV re, Ow nrlf rnanrr,
23. Ske diagram or sddlliatrst +Yell details:
You may we the bock of this page to provide additional well site details or veil
ronstnictiilai details. You may also attach additional pages if itecessan -
5I IBMITTAL INSTUCTIONS
girt. fir All Suhnat this form within 30 days a'f compeiion of 'Nell
Cn 1ntcrion to the follosing-
Ift.1 I)hWon of Water Rrroanets. Info raastiu i Ptucnaing
1617 Mail Sender ('cater. RLkigir. N(:27699.1617
24b. for lttietriar }elk ONES: In addition to sending the form ro the address in
24a above, also submit a copy of dais funs u ithin 30 day of completion of well
construction id Ih ftyllo via .
Dh Islam of Water Resources, Underground Injection Control Program.
1636 Maki Semler ('enter. Raleigh. (C 27699.1636
23c. For Water Sal*p1. & Injection R'dis:
Also submit one cop}' of this faun within 1n days or completion of
well construction to the county health deponutuit of the county intone
constructed
FOR WATER SUPPLY WELLS ONLY:
13a, Yidd Wpm)
13b. Disinfection tape t
Method of tcalt:
Amount:
Rim OW- l
hold) CLr01111:1 fJpannriuof Emuolutclla 21
rd Nni.ria1 Rcsour.rs - Iln t, loll of WA'nicr itesaxrrn
kn tscel August 2011

Permit Number
Program Category
Deemed Ground Water
Permit Type
WI0400485
Injection Deemed In-situ Groundwater Rem~iation Well
Primary Reviewer
shristi.shrestha
Coastal SWRule
Permitted Flow
Facility
Facility Name
Former Rental Towel & Uniform Services Site
Location Address
610Woody Dr
Graham
Owner
Owner Name
Cintas Corporation
Dates/Events
NC
Orig Issue
5/25/2018
App Received
5/12/2018
Regulated Activities
Groundwater remediation
Outfall
Waterbody Name
27253
Draft Initiated
Scheduled
Issuance Public Notice
Central Files: APS __ SWP
6/1/2018
Permit Tracking Slip
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Winston-Salem
County
Alamance
Facility Contact Affiliation
Owner Type
Non-Government
Owner Affiliation
Lisa Autrey
27 Whitney Dr
Milford
Issue
5/25/2018
Effective
5/25/2018
OH 45150
Expiration
Requested /Received Events
Streamlndex Number Current Class Subbasin
North Carolina Department of Environmental Quality -Division of Water Resources
NOTIFICATION OF INTENT (NOi) TO CONSTRUCT OR OPERATE INJECTION WELLS
The following are "permitted by rule" and do not require an individual permit when constructed in accordance
with the rules of 15A NCAC 02C .0200. This form shall be submitted at least 2 WEEKS prior to injection.
AQUIFER TEST WELLS 0 5A NCAC 02C .0220 )
These wells are used to inject uncontaminated fluid into an aquifer to determine aquifer hydraulic characteristics.
IN SITU REMEDIATION (1 5A NCAC 02C .0225 ) or TRACER WELLS (1 5A NCAC 02C .0229 ):
I) Passive Injection Systems -In-well delivery systems to diffuse injectants into the subsurface. Examples include
ORC socks, iSOC systems, and other gas infusion methods.
2) Small-Scale Injection Operations -Injection wells located within a land surface area not to exceed I 0,000
square feet for the purpose of soil or groundwater remediation or tracer tests. An individual permit shall be required
for test or treatment areas exceeding 10,000 square feet.
3) Pilot Tests -Preliminary studies conducted for the purpose of evaluating the technical feasibility of a
remediation strategy in order to develop a full scale remediation plan for future implementation, and where the
surface area of the injection zone wells are located within an area that does not exceed five percent of the land
surface above the known extent of groundwater contamination. An individual permit shall be required to conduct
more than one pilot test on any separate groundwater contaminant plume.
4) Air Injection Wells -Used to inject ambient air to enhance in-situ treatment of soil or groundwater.
Print Clearly or Type Information. Illegible Suhmittals Will Be Returned As Incomplete.
DATE: April 10 . 2018 PERMIT NO. h,.;.::l. 0 4-0 0 C/-8 S (to be filled in by DWR)
A. WELL TYPE TO BE CONSTRUCTED OR OPERATED
B.
C.
--~Air Injection Well ...................................... Complete sections B through F, K, N
--~Aquifer Test Well ....................................... Complete sections B through F, K, N
--~Passive Injection System ............................... Complete sections B through F, H-N
___ Small-Scale Injection Operation ...................... Complete sections B through N
(I)
(2)
(3)
(4)
(5)
(6)
=X~_-Pilot Test ................................................. Complete sections B through N RECEIVEO!NCDEQ/DWR
___ Tracer Injection Well ................................... Complete sections B through N
MAY l.r2 2018
STATUS OF WELL OWNER: Business/Organization Water Quality
Regional Open;itions Section
WELL OWNER(S) -State name of Business/ Agency, and Name and Title of person delegated authority to
sign on behalf of the business or agency:
Name(s): Cintas Corporation. Lisa Autre (Chemical/Environmental Ene ineer)
Mailing Address: 27 Whitne y Drive
City: Milford State: OH Zip Code: 45150 County:_C=le=rm=o=n=t'------
Day Tele No.: 513-965-4964 Cell No.: __________ _
EMAIL Address: autrevlr@ cintas.com Fax No.: ___ 8_66_-_84_4_-9_6_0_4 ___ _
Deemed Permitted GW Remediation NOi Rev. 3-1-2016 Page 1
D. PROPERTY OWNER(S) (if different than well owner)
Name and Title:
Company Name __________________________ _
Mailing Address: _________________ _
City: ____ State: __ Zip Code: ___ County: _____ _
DayTeleNo.: _____________ CellNo.: ________ _
EMAIL Address:______ Fax No .: ___________ _
E. PROJECT CONT ACT (Typically Environmental Engineering Firm)
Name and Title: Matthew Allen (Project Manager)
Company Name AECOM Technical Services of North Carolina
Mailing Address: 1600 Perimeter Park Drive. Suite 400 Morrisville. NC 27560
City: Morrisville State: NC Zip Code: 27560 County:-'Wc:...ak=e'-----
Day Tele No.: 919-461-1434 Cell No.: 919-500-9716
EMAIL Address: matthew.allenral aecom.com Fax No.: 919-461-1415
F. PHYSICAL LOCATION OF WELL SITE
(1) Facility Name & Address: Former Rental Towel and Uniform Services Site. 610 Woody Drive
City: Graham County: Alamance Zip Code: --=2~72=5~3~
(2) Geographic Coordinates: Latitude**: JQ_0
• 058711
Longitude**: -79 °.~3~8~36=8=2~---
Northing, Easting: ________ _
Reference Datum: NAD 83
Accuracy: +/- 1 cm
Method ofCollection:_-'G=o"-'o=g=le=--=E=arth==--------------
* *FOR AIR INJECTION AND AQUIFER TEST WELLS ONLY: A FACILITY SITE MAP WITH PROPERTY
BOUNDARIES MAY BE SUBMITTED IN LIEU OF GEOGRAPHIC COORDINAT ES .
G. TREATMENT AREA
Land surface area of contaminant plume: 2 . 7 54.303 square feet
Land surface area ofinj. well network: 850 square feet(.::: 10,000 ft2 for small-scale injections)
Percent of contaminant plume area to be treated: 0.03% (must be.::: 5% of plume for pilot test injections)
H. INJECTION ZONE MAPS -Attach the following to the notification.
(1) Contaminant plume map(s) with isoconcentration lines that show the horizontal extent of the
contaminant plume in soil and groundwater, existing and proposed monitoring wells , and existing and
proposed injection wells; and
(2) Cross-section(s) to the known or projected depth of contamination that show the horizontal and
vertical extent of the contaminant plume in soil and groundwater, changes in lithology, existing and
proposed monitoring wells, and existing and proposed injection wells.
(3) Potentiometric surface map(s) indicating the rate and direction of groundwater movement, plus
existing and proposed wells.
Deemed Permitted GW Remediation NOi Rev. 3-1-2016 Page2
I. DESCRIPTION OF PROPOSED INJECTION ACTMTIES -Provide a brief narrative regarding the
purpose, scope, and goals of the proposed injection activity. This should include the rate, volume, and
duration of injection over time.
The ERD in jection pilot study will be performed to evaluate material distribution in the subsurface
and to confirm a ppro priate loading rates. The pilot stud will be performed via injection into an existing welL
EW-6. A pp roximate! 2,500 gallons of a substrate solution containing 2 ,100 lbs of Electron Donor Solution -
EDS-ER®. 750 lbs of sodium bicarbonate. and 5 gallons of Nutrimens ® will be in jected via gravity tech-
ni ques or using a pneumatic double diaphragm pump to achieve a targeted injection rate of 0.5 gallons per
minute. The Pilot study will take a pproximately five days to comp lete on-site.
In a se parate mobilization. bioaugmentation will be performed with a dehalores pirin g culture. The
bioaugmentation procedure will consist of the a pp lication of a pproximately 3 liters of KB-1 ®. An IBC tote
(275 gallons) will be filled with the EDS-ER® (230 lbs ) and bicarbonate solution {1 00 lbs ), as described above
and amended with a pp roximate! 2 pounds of KB-1 primer . The KB-1 primer will create anaerobic conditions
within the water and limit inactivation of the KB-1® culture. which is hi ghly sensitive to aerobic conditions.
The bioaugmentation will take approximatel y one da to complete on-site.
J. APPROVED INJECT ANTS -Provide a MSDS for each injectant. Attach additional sheets if necessary.
NOTE: Only injectants approved by the NC Division of Public Health, Department of Health and Human
Services can be irifected. Approved injectants can be found online at htt p://deg .nc.eov/about/divisions/water-
resources/water-resour ·es-permits/wastewater-branch/i!round-water-protection/ground-water-a pp roved-in jectants.
All other substances must be reviewed by the DHHS prior to use. Contact the UIC Program for more info
(919-807-6496).
Source Area (1 Injection Well)
lnjectant: --=E=D~S~-E=R~®~-----------------------
Volume ofinjectant: U p to 2.330 lbs ofEDS-ER®
Concentration at point of injection: ~ 0.84 pounds per gallons EDS-ER®
Percent if in a mixture with other injectants: ~ 10 percent b y weight
Injectant: Sodium Bicarbonate
Volume of injectant: __ ~....;8::..:5;...:0'--'l=b-=-s ______________ _
Concentration at point of injection: ___ ~0-----=-.,•=3__,p'--=o'-"u=n=d=s -"'p=e.:..r ""e=al:.:.lo""n=so=d=i=um==--b=ic=ar=b=o=n=a=te=--------
Percent if in a mixture with other injectants: ___ ~_.3'-'p""e::.::r-=ce""n~t'-"b=-y~w,;e.:.:ig""h=t _______ _
lnjectant: __ """KB~-~1-® _______________________ _
Volume of injectant: __ 3~L=it=e=rs=------------------------
Concentration at point of injection: __ .....:.,10=--/\--'l""'l'-c"""'e=ll=s__,.p=-=e=r~h=·te=r'-------------
Percent if in a mixture with other injectants: ---~--=2=·-=-88=----&p=e~rc'-"e=n=t=b.,_y"""v--=o=lu=m=e _________ _
Injectant: __ ....aKB=~-l=P--=r=im=er'-®=--------------------------
Volume of injectant: -"""2~lb""'s'-------------------------
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page3
Concentration at point of injection: ~0.007 pounds per gallon KB-1 Primer ®
Percent if in a mixture with other injectants: ______ ~_0=·~0~8 .... p~e~rc=e=n=t~b-v_w~ei...,gh~t ______ _
lnjectant: --~N"-'-"'u=tr=im=en=s=®=---------------------
Volume ofinjectant: 5 allons
Concentration at point of injection: ___ ~_0=·=0--"0=2----cg=a=ll=on=s"-""pe=r'---!.!.;:,a'a=l=lo=n"'--_______ _
Percent if in a mixture with other injectants: ~0.2 percent by volume
K. WELL CONSTRUCTION DATA
(1) Number of injection wells: _O __ Proposed ___ ~l ___ Existing (provide GW-ls)
(2) For Proposed wells or Existing wells not having GW-ls, provide well construction details for each
injection well in a diagram or table format. A single diagram or line in a table can be used for
multiple wells with the same construction details. Well construction details shall include the
following (indicate if construction is proposed or as-built):
(a) Well type as permanent, Geoprobe/DPT, or subsurface distribution infiltration gallery
(b) Depth below land surface of casing, each grout type and depth, screen, and sand pack
( c) Well contractor name and certification number
L. SCHEDULES -Briefly describe the schedule for well construction and injection activities.
Performance monitorine wells will be constructed after the submittal of the notification to allow NCDE O
review. EW-6 (in jection we ll) and new performance monitoring wells will be sampled for baseline conditions
a pproximatel v one (1 ) week after construction completion. In jection activities will be initiated after anal yt ical
data are received within a pp roximatel y four (4 ) weeks of the baseline sampling. Initial injection activities will
involve the a pp lication of the EDS-ER®/sodium bicarbonate/Nutrimens® solution. If monitoring data sugg est
that app ro priate dechlorinatin g bacteria are not being established. then additional in jections will be performed
to bioaugment with KB-1 ®. a pro prietary dechlorinating culture.
M. MONITORING PLAN -Describe below or in separate attachment a monitoring plan to be used to determine
if violations of groundwater quality standards specified in Subchapter 02L result from the injection activity.
Groundwater chemis t:J in the in jection area, including pH, conductivi t . oxidation reduction potential. and
dissolved oxygen will be monitored on a re gular basis before , durin g. and after the in jection event(s).
Groundwater will also be monitored for volatile organic com pounds (VOCs). total or ganic carbon (TOC).
electron acce ptors/de 1tradation products . microbial assav/functional genes and metabolic acids. Pro posed
monitoring of groundwater will be completed within the year following the in jections. Performance monitoring
events will be completed durin g the pro posed months followin g injection: Month 1. Month 2. Month 3 . Month
6. Month 9 and Month 12. See attached Table 2 for a detailed descri ption of the monitoring plan.
Deemed Permitted GW Remediation NOI Rev. 3-1-2016 Page 4
N. SIGNATURE OF APPLICANT AND PROPERTY OWNER
APPLICANT: "1 hereby certify, under penalty of law, that 1 am ,familiar with the information submitted in
this document and all attachments thereto and that, based on my inquiry of those individuals immediately
responsible for obtaining said information, 1 believe Mat Me information is true, accurate and complete. I am
aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting
false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well
and ald •,'elated zpp renances in accordance with the I SA MAC 02C 0200 Rules."
� (1-4.ui Liam ui11 c
Signature of Applicant Print ur Type Full Name and Title
PROPERTY OWNER (lithe property is nor owned b0. the permit applicants:
"As owner of the property on which the injection well(s) are to be constructed and operated, 1 hereby consent
to allow the applicant to construct each injection well as outlined in this application and agree that it shall be
the responsibility of the applicant to ensure that the injection well(s) conform to the Well Construction
Standards (15A NCAC 02C , 0200+. "
"Owner" means any person who holds the fee or other property rights in ttie well being constructed. A
well is real property and its construction on land shall be deemed to vest ownership in the land owner, in
the absence of contrary agreement in writing.
Signature* of Property Owner (if different from applicant) Print or Type Full Name and Title
*An access agreement between the applicant and property owner may be submitted in lieu of a signature an this form.
Submit the completed notification package to:
DWR — tJIC Program
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone: [phone]
Deemed permitted GW Remediation NO1 Rev. 1-1-2014
Page 5

Attachments
Material Safety Data Sheet
Electron Donor Solution
teVSWS
envirenniErt¢f
Section 1: Chemical Product and Company Identification
Product Name: Electron Donor Solution
Extended Release
Catalog Codes: EDS-ER
CAS#: 8001-22-7
TSCA: TSCA 8(b) inventory: Soybean oil
HMIS Code: H F R P: 10 0 A
Trade Name and Synonyms: EDS-ER
Chemical Family: Glyceride Oils
Contact Information:
Tersus Environmental, LLC
109 E. 17th Street, Suite #3880
Cheyenne, WY 82001
Ph- 307.638,2822 • [e-mail]
www.tersusenv.com
For emergency assistance, call: 919.638,7892
Section 2: Composition and Information on Ingredients
COMPONANT
Soybean Oil
Vegetable Oil Derived Fatty
Acid Esters
OSHA OSHA
CAS # TWA STEL
8001-22-7
Confidential
10 mg/m3
ACGIH ACGIH
TWA STEL
HAZARDOUS INGREDIENTS: NONE AS DEFINED UNDER THE U.S. OSHA HAZARD
COMMUNICATION STANDARD (29 CFR 1910.1200) OR TF-IE CANADIAN HAZARDOUS PRODUCTS.
ACT S.C. 1987, C.30 (PART 1).
THE PRECISE COMPOSITION OF THIS PRODUCT IS PROPRIETARY INFORMATION. A MORE
COMPLETE DISCLOSURE WILL BE PROVIDED TO A PHYSICIAN IN THE EVENT OF A MEDICAL
EMERGENCY,
SARA HAZARD: NONE NOTED (SECTION 311/312) TITLE III SECTION 313 - NOT LISTED
All components of this product are listed cn the TSCA registry
[Section 3: Physical/Chemical Characteristics
BOILING RANGE: Not applicable VAPOR DENSITY: Exceeds 1.0
SPECIFIC GRAVITY (H20=1.0)- 0.92 - 0.925 VAPOR PRESSURE: Not applicable
PERCENT VOLATILE BY VOLUME 0%SOLUBILITY IN WATER: Miscible
EVAPORATION RATE; Not applicable
APPEARANCE AND ODOR: A pale yellow, oily liquid - only a faint odor.
WEIGHT PER GALLON: 7.7 lbs. at 60F
Matenal Safety Data Sheet Date: May 11, 2011
Page 1 Rev. Date: January 24. 2013

te rsus
MVr r EPOKIRntof
Material Safety Data Sheet
Section 4: Fire and Explosion Data
FLAMMABILITY CLASSIFICATION: Combustible Liquid - Class IIIB.
FLASHPOINT: Greater than 550 F (288 C).
METHOD USED: Tag Closed Cup.
EXTINGUISHING MEDIA: CO2, dry chemical, foam, sand.
SPECIAL FIREFIGHTING PROCEDURES: Avoid use of water as it may spread fire by dispersing oil.
Use water to keep fire -exposed containers cool, Water spray may be used to flush spills away from fire.
UNUSUAL FIRE AND EXPLOSION HAZARDS: Rags soaked with any oil or solvent can present a fire
hazard and should always be stored in UL Listed or Factory Mutual approved, covered containers.
Improperly stored rags can create conditions that lead to oxidation. Oxidation, under certain conditions
can lead to spontaneous combustion.
I Section 5: Reactivity Data
STABILITY: Generally stable. Spontaneous combustion can occur. See Unusual Fire and Explosion
Procedures, Section IV.
CONDITIONS TO AVOID: High surface area exposure to oxygen can result in polymerization and release
of heat.
INCOMPATABILITY (MATERIALS TO AVOID): Avoid contact with strong oxidizing agents.
HAZARDOUS DECOMPOSITIONS OR BY-PRODUCTS: Decomposition may produce carbon dioxide
and carbon monoxide.
HAZARDOUS POLYMERIZATION: Will not occur.
Section 6: Health Hazard Data
THRESHHOLD LIMIT VALUE: As a tiquid - none. As oil mist - 10 mglm3 total particulate.
INHALATION HEALTH RISKS AND SYMPTOMS OF EXPOSURE: Excessive inhalation of oil mist may
affect the respiratory system. Oil mist is classified as a nuisance particulate by ACGIH.
SKIN ABSORPTION HEALTH RISKS AND SYMPTOMS OF EXPOSURE: Not classified as a primary
skin irritant or corrosive material. Sensitive individuals may experience dermatitis after on exposure of
oil on skin.
HEALTH HAZARDS (ACUTE. AND CHRONIC): Acute: none observed by inhalation+. Chronic. none
reported.
EMERGENCY AND FIRST AID PROCEDURES FOR:
SKIN CONTACT: May be removed from skin by washing with soap and warm water
EYE CONTACT: Immediately flush eyes with plenty of cool water for at least 15 minutes. Do NOT let
victim rub eyes.
INHALATION: Immediately remove exposed individual to fresh air source. If victim has stopped breathing
give artificial respiration, get medical attention immediately.
Material Safety Data Sheet Date' May 11, 2011
Page 2 Rev, Date: January 24, 2013

i
tersL+s
lnrironnwitAi
M ateriat Safety Data Sheet
Section 7: Precautions for Safe Handling and Use
ENVIRONMENTAL PRECAUTIONS: Where large spills are possible, a comprehensive spill response
plan should be developed and implemented.
STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED: Wear appropriate respiratory
protection and protective clothing as described in section VIII. Depending on quantity of spill: (a) Small
spill - add solid adsorbent, shovel into disposable container and wash the area. Clean area with
detergent. (b) Large spill - Squeegee or pump into holding container. Clean area with detergent. In the
event of an uncontrolled release of this material, the user should determine if this release is reportable
under applicable laws and regulations.
WASTE DISPOSAL METHOD: All recovered material should be packaged, labeled, transported, and
disposed or reclaimed in accordance with local, state, and federal regulations and good engineering
practices.
Section 8: Control Measures
RESPIRATORY PROTECTION: Not normally needed. A qualified health specialist should evaluate
whether there is a need for respiratory protection under specific conditions.
VENTILATION: Handle in the presence of adequate ventilation. Intermittent clean air exchanges
recommended, but not required.
PROTECTIVE GLOVES: Not normally needed. However, protective clothing is always recommended
when handling chemicals.
EYE PROTECTION: Eye protection is always recommended when handling chemicals. Wear safety
glasses meeting the specifications established in ANSI Standard Z87.1.
Section 9: Special Precautions
PRECAUTIONS TO BE TAKEN IN HANDLING AND STORAGE: Store away from flame, fire, and
excessive heat.
Section 10: Disposal Considerations
General Information: Do not discharge into drains, watercourses or onto the ground. Discharge,
treatment, or disposal may be subject to national, state, or local laws. Ernpty containers may contain
product residues.
Disposal Methods: No specific disposal method required.
Container: Since emptied containers retain product residue, follow label warnings even after container is
emptied.
Material Safety Data Sheet Date: May 11, 2011
Page 3 Rev. Date: January 24, 2013

NSection
�`.EY'SuS
ek.�rar..xer,tal
Material Safety Data Sheet
11: Transportation Information
DOT Not regulated.
TOG Not regulated.
IATA Not regulated.
IMDG Not regulated.
Section 12: Other Information
Hazard Ratings
Health Hazard
Fire Hazard
Instability
Special Hazard
NFPA
1
1
_
0
NONE
Hazard rating 0 - Minimal; 1 - Slight; 2 - Moderate; 3 - Serious; 4 - Severe
NFPA Label colored diamond code: Blue - Health; Red - Flammability; Yellow - Instability; White - Special
Hazards
Health Hazard
Flammability
Physical Hazard Personal Protection
1
1
0 I --
Hazard rating- 0 - Minimal; 1 - Slight; 2 - Moderate; 3 - Serious; 4 - Severe
HMIS Label colored bar code: Blue - Health; Red - Flammability; Orange - Physical Hazards; White -
Special
Section 13: Disclaimer and/or Comments
We suggest that containers be either professionally reconditioned for re -use by certified firms or properly
disposed of by certified firms to help reduce the possibility of an accident. Disposal of containers should
be in accordance with applicable federal, state and local laws and regulations. 'Empty" drums should not
be given to individuals.
The conditions of handling, storage, use and disposal of the product are beyond our control and may be
beyond our knowledge. For this and other reasons, we do not assume responsibility and expressly
disclaim liability for loss, damage or expense arising out of or in any way connected with the handling,
storage, use or disposal of the product.
The information above is believed to be accurate and represents the best information currently available
to us. However, we make no warranty of merchantability or any other warranty, express or implied, with
respect to such information, and we assume no liability resulting from its use. Users should make their
own investigations to determine the suitability of the information for their particular purposes. In no event
shall Tersus Environmental be liable for any claims, losses, or damages of any third party or for lost
profits or any special, indirect, incidental, consequential or exemplary damages, howsoever arising, even
if Tersus Environmental has been advised of the possibility of such damages.
Material Safety Data Sheet Date: May 11, 2011
Page 4 Rev. Date: January 24. 2013

~ MATERIAL SAFETY DATA SHEET PAGE 01 OF 04
SODIUM BICARBONATE
1. IDENTIFICATION OF THE SUBSTANCE AND COMPANY
Product SODIUM BICARBONATE
Chemical Name Sodium Bicarbonate.
Alternative Name Bicarbonate of Soda. Baking Soda, Soda Bicarb
Sodium Hydrogen Carbonate.
Chemical Formula NaHCO3
Manufacturing Sites Gujarat, Saurashtra
Company Address GHCL Limited,
Sutrapada, Dist. Gir Somnath
Gujarat.
Telephone Number 02876-263401,263402,263403
Fax No. 02876 -263480, 263483
2. COMPOSITION/ INFORMATION ON INGREDIENTS
-Sodium Bicarbonate
CAS Number 144 -55 - 8
EC Number 205-633 8
3. HAZARDS IDENTIFICATION
- A substance of low toxicity widely used in food and medicine.
-Treat as low toxicity dust
-No significant health or environmental hazards associated with the material
4. FIRST AID MEASURES
Inhalation
-Remove to fresh air
Skin Contact
-Wash skin with plenty of water
-If irritation occurs and persists seek medical advice
Eye Contact
-Irrigate eye thoroughly with eye wash solution or clean water for at least 10 minutes.
-Eyelids should be held away from the eyeball to ensure through rinsing.
-Obtain medical attention if necessary.
Ingestion
-DO NOT induce vomiting
l -Wash out mouth with water and give plenty of water to drink (at least 300 ml.
-Obtain medical attention if necessary.
l
:: SiRE
Ingestion: Do not induce vomiting, drink several cups of water, seek medical attention.
Inhalation: Remove to fresh air. If not breathing give artificial respiration. In case of labored breathing
give oxygen. Call a physician .
Section 5 -Fire Fighting Measures:
Non-flammable
Flash Point: not applicable
Upper flammable limit: not applicable
Lower flammable limit: not applicable
Section 6 -Accidental Release Procedures
Spilled KB-1® should be soaked up with sorbant and saturated with a 10% bleach solution (prepared by
making a one in ten dilution of diluted standard bleach [normally sold at a strength of 5.25% sodium
hypochlorite] to disinfect affected surfaces . Sorbant should be double bagged and disposed of as
indicated in section 12. After removal of sorbant , area should be washed with 10% bleach solution to
disinfect. If liquid from the culture vessel is present on the fittings , non-designated tubing or exterior of the
stainless steel pressure vessel liquid should be wiped off and the area washed with 10% bleach solution .
Section 7 -Handling and Storage
KB-1® is shipped in stainless steel pressure vessels and connected to injection lines and inert gas is used
to pressurize the vessel to displace the contents . KB-1 ® should be handled with care to avoid any
spillage. Vessels are shipped with 1 pound per square inch (psi) pressure; valves should not be opened
until connections to appropriate lines for subsurface injection are in place.
Storage Requirements: Avoid exposing stainless steel pressure vessels to undue temperature
extremes (i.e ., temperatures less than 0°C or greater than 30°C may result in harm to the microbial
cultures and damage to the vessels). All valves should be in the closed position when the vessel is not
pressurized or not in use to prevent the escape of gases and to maintain anaerobic conditions in the
vessel. Avoid exposure of the culture to air as the presence of oxygen will kill dechlorinating
microorganisms.
Section 8 -Exposure Controls/Personal Protection
Personal protective equipment:
Skin: Protective gloves (latex , vinyl or nitrile) should be worn .
Eye Protection : Wear appropriate protective eyeglasses or goggles when opening pressure vessels ,
valves , or when pressurizing vessels to inject contents into the subsurface .
Respiratory : No respiratory protection is required .
Engineering Controls : Good general room ventilation is expected to be adequate .
Section 9: Physical and Chemical Properties:
Physical State: liquid
Odour: skunky odour
Appearance: dark grey, slightly turbid liquid under anaerobic conditions, pink if exposed to air (oxygen).
Specific gravity: not determined
Vapor pressure: not applicable
Vapor density: not applicable
Evaporation rate : not determined
Boiling point: ~100° C
Freezing point/melting point: ~ 0°C
KB ·f siremlab. com 2/4
l
l
l
pH: 6.5-7.5
Solubility: fully soluble in water
Section 10 -Stabili ty and Reactivity Data
Stable and non-reactive.
Maintain under anaerobic conditions to preserve product integrity.
Materials to avoid: none known
Section 11 -Toxicolog ical Information
Potential for Pathogenicity:
:. SiRE
KB-1® has tested negative (i.e., the organisms are not present) for a variety of pathogenic organisms
listed in Table 2. While there is no evidence that virulent pathogenic organisms are present in KB-1®,
there is potential that certain organisms in KB-1® may have the potential to act as opportunistic (mild)
pathogens, particularly in individuals with open wounds and/or compromised immune systems. For this
reason standard hygienic procedures such as hand washing after use should be observed.
Table 2, Results of Human Pathogen Screening of KB-1® Dechlorinator
Organism Disease(s) Caused Test result
Salmonella sp. Typhoid fever, gastroenteritis Not Detected
Listeria monocytogenes Listerioses Not Detected
Vibrio sp., Cholera, gastroenteritis Not Detected
Campylobacter sp., Bacterial diarrhea Not Detected
Clostridia sp., Food poisoning, Botulism, tetanus, gas gangrene Not Detected
Bacillus anthracis Anthrax Not Detected
Pseudomonas aeruginosa Wound infection Not Detected
Yersinia sp., Bubonic Plague, intestinal infection Not Detected
Yeast and Mold Candidiasis, Yeast infection etc. Not Detected
Fecal coliforms Indicator organisms for many human pathogens diarrhea, urinary Not Detected
tract infections
Enterococci Various opportunistic infections Not Detected
Section 12. Dis posal Considerations
Material must be disinfected or sterilized prior to disposal. Consult local regulations prior to disposal.
Section 13-Transport Information
Non-hazardous, non-pathogenic microbial inoculum -Biosafety Risk Group 1.
Chemicals, Not Otherwise Indexed (NOi), Non-hazardous
Not subject to TOG or DOT guidelines.
KB •f I siremlab.com 3/4
Disclaimer:
• • SiREM
The information provided on this MSDS sheet is based on current data and represents our opinion based
on the current standard of practice as to the proper use and handling of this product under normal,
reasonably foreseeable conditions.
Last revised: 2 August 2011
KB ·f siremlab. com 4/4
SiREM
Leading Science • Lasting Solutions
KB-1° Plus Material Safety Data Sheet
Section 1: Material Identification
Trade Name: KB-e Plus
Chemical Family: bacterial mixture
Chemical name: No FUC name for mixture is known to exist
Manufacturer/Supplier: SIREM
130 Research Lane. Suite 2,
Guelph, Ontario,
Canada N1G 5G3
For Information call: 519-822-2265 / 1-866-251-1747 x236
Emergency Number: 519-822-2265
Description:
Trade Name:
Product Use:
Date Prepared:
Microbial inoculum (non-pathogenic, non -hazardous)
KB-1Plus
Bioremediation of contaminated groundwater.
23 October 2008
ILO b a emeh Leee, Ste 2
GvnrtiG 5{i.3
(5t916214265
Section 2: ComoositionLInformation on Ingredients
KB-1e' Pius is a microbial culture grown in a dilute aqueous mineral salt solution media containing no
hazardous ingredients.
The microbial composition of KB-1` Plus is listed in Table 1.
Table 1. Major Microbial Groups Identified In KB-1* Plus Microbial inoculum
Dehalococcoides sp.
Geobacier sp.
Methanomethylovorans sp.
Dehalobacter sp.
Dehalogenimonas sp.
Section 3: Hazards identification:
A review of the available data does not indicate any known health effects related to normal use of this
product,
Section 4: First Aid Measures:
Avoid direct contact with skin and eyes. In any case of any exposure which elicits a response, a
physician should be consulted immediately.
Eye Contact: Flush eyes with water for at least 15 minutes, occasionally lift upper and lower eyelids, if
undue irritation or redness occurs seek medical attention.
Skin Contact: Remove contaminated clothing and wash skin thoroughly with water and antibacterial
soap. Seek medical attention if irritation develops or open wounds are present.
KB'1p: slrernlab. coot 1 /3

■• SiRE
Ingestion: Do not induce vomiting, drink several cups of water, seek medical attention.
Inhalation: Remove to fresh air. If not breathing give artificial respiration. In case of labored breathing
give oxygen. Call a physician.
Section 5 -Fire Fighting Measures:
Non-flammable
Flash Point: not applicable
Upper flammable limit: not applicable
Lower flammable limit: not applicable
Section 6 -Accidental Release Procedures
Spilled KB-1® Plus should be soaked up with sorbant and saturated with a 10% bleach solution (prepared
by making a one in ten dilution of diluted standard bleach [normally sold at a strength of 5.25% sodium
hypochlorite] to disinfect affected surfaces. Sorbant should be double bagged and disposed of as
indicated in section 12. After removal of sorbant, area should be washed with 10% bleach solution to
disinfect. If liquid from the culture vessel is present on the fittings, non-designated tubing or exterior of the
stainless steel pressure vessel liquid should be wiped off and the area washed with 10% bleach solution.
Section 7 -Handling and Storage
KB-1® Plus is shipped in stainless steel pressure vessels in a protective over pack. KB-1® Plus should be
handled with care to avoid any spillage. Vessels are shipped with 1 pound per square inch (psi)
pressure; valves should not be opened until connections to appropriate lines for subsurface injection are
in place.
Storage Requirements: Avoid exposing stainless steel pressure vessels to undue temperature
extremes (i.e., temperatures less than 0°C or greater than 30°C may result in harm to the microbial
cultures and damage to the vessels). All valves should be in the closed position when the vessel is not
pressurized or not in use to prevent the escape of gases and to maintain anaerobic conditions in the
vessel. Avoid exposure of the culture to air as the presence of oxygen will kill dechlorinating
microorganisms.
Section 8 -Exposure Controls/Personal Protection
Personal protective equipment:
Skin: Protective gloves (latex, vinyl or nitrile) should be worn.
Eye Protection: Wear appropriate protective eyeglasses or goggles when opening pressure vessels,
valves, or when pressurizing vessels to inject contents into the subsurface.
Respiratory: No respiratory protection is required.
Engineering Controls: Good general room ventilation is expected to be adequate.
Section 9: Physical and Chemical Properties:
Physical State: liquid
Odour: skunky odour
Appearance: dark grey, slightly turbid liquid under anaerobic conditions, pink if exposed to air (oxygen).
Specific gravity: 1
Vapor pressure: not applicable
Vapor density: not applicable
Evaporation rate: not determined
Boiling point: ~100° C
Freezing point/melting point: ~ 0°C
KB .1p1us• I '.l siremlab. com 2/3
pH: 6.5-7.5
Solubility: fully soluble in water
Section 10 -Stabili ty and Reactivity Data
Stable and non-reactive.
Maintain under anaerobic conditions to preserve product integrity.
Materials to avoid : none known
Section 11 -Toxicolog ical Information
Potential for Pathogenicity:
:. SiRE
KB-1 ® Plus has tested negative (i.e., the organisms are not present) for a variety of pathogenic organisms
listed in Table 2. While there is no evidence that virulent pathogenic organisms are present in KB-1® Plus,
there is potential that certain organisms in KB-1 ® Plus may have the potential to act as opportunistic (mild)
pathogens, particularly in individuals with open wounds and/or compromised immune systems. For this
reason standard hygienic procedures such as hand washing after use should be observed .
Table 2, Results of Human Pathogen Screening of KB-1®Plus
Organism Disease(s) Caused Test result
Salmonella sp . Typhoid fever, gastroenteritis Not Detected
Listeria monocytogenes Listerioses Not Detected
Vibrio sp., Cholera, gastroenteritis Not Detected
Campylobacter sp., Bacterial diarrhea Not Detected
Clostridia sp., Food poisoning , Botulism , tetanus, gas gangrene Not Detected
Bacillus anthracis Anthrax Not Detected
Pseudomonas aeruginosa Wound infection Not Detected
Yersinia sp ., Bubonic Plague, intestinal infect ion Not Detected
Yeast and Mold Candidiasis, Yeast infection etc . Not Detected
Fecal coliforms Indicator organisms for many human pathogens diarrhea , urinary Not Detected
tract infections
Enterococci Various opportunistic infections Not Detected
Section 12. Dis posal Considerations
Material must be disinfected or sterilized prior to disposal. Consult local regulations prior to disposal.
Section 13-Transport Information
Non-hazardous, non-pathogenic microbial inoculum
Chemicals, Not Otherwise Indexed (NOi), Non-hazardous
Not subject to TOG or DOT guidelines.
Disclaimer:
The information provided on this MSDS sheet is based on current data and represents our
opinion based on the current standard of practice as to the proper use and handling of this
product under normal , reasonably foreseeable conditions .
Last revised: 12 June 2012
KB .1 p1wo• I '.l siremlab.com 3/3
!: SiREM
Leading Science Lasting Solutions
Chemical Components in KB-1® Growth Media
I Al Research Law, Sur 2
Guelph ON NIG 5G3
lS19i 112 -12fi5
KB-1® consists of a microbial culture grown in a mineral salts media containing the
ingredients listed in Table 1.
Table 1: Chemical Ingredients of KB-1® growth media
Chemical Name
Formula
CAS#
Concentration
grams/Liter
Potassium Phosphate Dibasic
KH2PO4
7758-11-4
0.27
Potassium Phosphate Monobasic
K2HPO4
7778-77-0
0.34
Ammonium Chloride
NH4CI
12125-02-9
0.535
Calcium Chloride
CaCl2
10035-04-8
0.07
Magnesium Sulfate
Mg504
10034-99-8
0.125
Ferrous Chloride
FeCl2
13478
0.02
r
Sodium bicarbonate _
,
NaHCO3
144-55-8
2.0
Ferrous Ammonium Sulfate
(NH4)2Fe(SO4)2
7783-85-9
0.4
r
Sodium sulfide
Na2S
1313-84-4
0.12
Resazurin
C12H8NNaO4
62758-13-8
0.001
r
Boric Acid
H3B03
10043-35-3
0.0006
Zinc Chloride
ZnCI
7646-85-7
0.0002
Sodium Molybdate
Na2Mo04
10102-40-6
0.0002
Nickel II Chloride
NiCl2
7791-20-0
0.0015
Manganese Chloride
MnCl2
13446-34-9
0.002
Copper III Chloride
CuCi2
10125-13-0
_ 0.0002
Cobalt Chloride
CaCl2
7791-13-1
0.003
Disodium Selenite
Na2Se03
10102-18-8
0.00004
Aluminum Trisulfate
Al2(304)3
10043-01-3
0.0002
Vitamins
Various
Various
0.01 maximum
KB1
GiiP_fisiat). cef l

SiREM
SAFETY DATA SHEET
1. CHEMICAL IDENTIFICATION AND COMPANY INFORMATION
Product Name: KI3-1 Primer
Company Info: SiREM
130 Stone Rd. W., Guelph, Ontario, Canada N1G 372
Phone: [phone]
Toll Free, North America: 1-866-251-1747
Fax: [phone]
www.siremiab.00rn
Emergency Phone Number:
Recommended Use:
Restrictions on Use:
Rev. No.: 0
Date: 8 March 2016
Page: 1 of 7
519-515-0840 (for 24/7 assistance, contact poison center hotline
in your;urisdiction).
For preparation of anaerobic water for use in groundwater
remediation.
KB1® products are intended for laboratory research and field
applications for groundwater remediation. Products are not
intended to be used as human or animal therapeutics, cosmetics,
agricultural or pesticidal products, food additives, or as household
chemicals.
2. HAZARDS IDENTIFICATION
GHS Classification: H302 — Acute toxicity, Oral (Category 4)
H319 — Eye irritant (Category 2)
GHS Label elements, including hazard and precautionary statements:
Signal Word: WARNING
Pictogram:
Hazard Statements:
H302 — Harmful is swallowed.
H315 — Causes skin irritation.
H319 — Causes serious eye irritation.
H335 — May cause respiratory irritation.
H402 — Harmful to aquatic life.
Precautionary Statements: P264 — Wash hands thoroughly after handling.
P270 — Do not eat, drink or smoke when using this product.
P273 — Avoid [unintended or indiscriminate] release to the environment.
KB-1 sitemlab.E.nrri
fRI4F.

HMIS Health
Rating: 1
NFPA Health
Rating: 1
Rev. No.: 0
Date: 8 March 2016
Page: 2 of 7
P280 -Wear protective gloves/protective clothing/eye protection/face
protection.
P301+P312 IF SWALLOWED: Call a POISON CENTER or doctor/
physician if you feel unwell.
P308 + P313 -If exposed or concerned: Get medical advice/attention.
P305+P351 +P338 IF IN EYES: Rinse cautiously with water for
several minutes. Remove contact lenses. Continue rinsing.
P337+P313 If eye irritation persists: Get medical advice/attention.
P330 -Rinse mouth.
P501 -Dispose of contents/container in accordance with
local/regional/national regulations.
Flammability Ph ysical Hazard Personal Protection
0 0 E*
Flammability Reactivi ty Special Hazard
0 0 N/A
* E = Safety Glasses, Gloves, Dust Respirator.
3. COMPOSITION/INFORMATION ON INGREDIENTS
Amino Acid (proteinogenic): 50-70%, C3H7NO2S
Potassium Bicarbonate: 25-50%, KHCO3, GAS No. 298-14-6
5-20%, Na2O3S, GAS No. 7757-83-7 Sodium Sulfite:
4. FIRST AID MEASURES
Avoid direct contact with skin and eyes. In any case of any exposure which elicits a response, a
physician should be consulted immediately.
Route of Entry
Ingestion
Skin contact
Eye contact
Inhalation of
dust
Symptoms
Irritation of digestive tract.
Skin irritation -reddening,
itching or inflammation.
Eye irritation -redness,
tearing, blurred vision.
Respiratory irritation,
coughing.
First Aid Procedures
DO NOT INDUCE VOMITING. Rinse mouth. Give
plenty of water to drink, do not give active carbon.
Never give anything by mouth to an unconscious
person. Get medical attention immediately.
Remove contaminated clothes. Wash skin with plenty
of water and soap.
Rinse immediately with plenty of water for 15 -20
minutes, lifting lower and upper eyelids occasionally
(remove contact lenses if easily possible). Seek
medical attention if undue irritation or redness occurs.
Safely remove victim to fresh air. If not breathing,
institute cardiopulmonary resuscitation (CPR). If
breathing is difficult, ensure clear airway and give
oxygen. Get medical attention.
KB-I I siremlab.com
PRIMER
Rev. No.: 0
Date: 8 March 2016
Page: 3 of7
I 5. FIRE FIGHTING MEASURES
I
l
l
Suitable extinguishing media:
Special protective equipment and
precautions for firefighters:
Hazardous combustion products:
Toxic gases produced:
Shock/impact sensitivity:
6. ACCIDENTAL RELEASE MEASURES
Ventilation:
Eye/skin protection:
Protective equipment for
airborne dust:
Method of containment and
cleanup:
7. HANDLING AND STORAGE
Handling and storage
precautions:
Incompatibilities:
Water in copious quantities, carbon dioxide, dry chemical powder,
or appropriate foam. Use extinguishing media suitable for
surrounding fire.
In the event of a fire, wear full protective clothing and NIOSH
approved self-contained breathing apparatus. Evacuate the area
and fight fire from a safe distance.
May emit toxic fumes under fire conditions.
Carbon monoxide, carbon dioxide, nitrogen oxides, potassium
oxides, sulfur oxides
Not shock sensitive.
If released in ventilated fume hood, ensure fume hood is on. If
released in general room environment, open windows and provide
adequate ventilation.
Have eye-washing facilities readily available where eye contact
can occur. Wear chemical safety goggles. Use appropriate
chemical protective gloves when handling. Showering and
changing into street clothes after work is recommended.
A NIOSH/MSHA approved air purifying respirator is recommended
where airborne concentrations are expected to exceed exposure
limits. Protection provided by purifying respirators is limited. Wear
suitable protective clothing and a self-contained breathing
apparatus if available.
Wear suitable protective clothing. Avoid dust formation. Avoid
breathing dust. Carefully sweep up and remove. Place material in
a dry container and cover. Remove from the area. Flush spill area
with water. Do not let products enter drains.
Store in a tightly sealed container in a cool, dry and well-
ventilated place. Store away from direct light. Avoid generation of
dust. Do not breathe dust. Wash thoroughly after handling. In
case of contact with eyes, rinse immediately with plenty of water
and seek medical advice. Wear suitable protective clothing.
Segregate from strong oxidizing agents, acids, bases.
KB-1 I siremlab.com
PRIMER
Rev. No.: 0
Date: 8 March 2016
Page: 4 of7
8. EXPOSURE CONTROLS/PERSONAL PROTECTION
OSHA Permissible Exposure
Limits (PELs):
ACHIH Threshold Limit
Values (Tl Vs):
Engineering controls:
Work practices:
Personal protective
equipment (PPE):
Not established.
Not established.
Generally not required under normal conditions of use. If
method of use will result in significant dust generation, use in lab
hood or under conditions of adequate ventilation.
Use good hygiene practices, avoid dust generation.
Under normal conditions of use, wear safety glasses and
protective gloves. For laboratory use, wear lab coat. For higher
risk of eye contact, wear safety goggles or face shield, as
appropriate.
9. PHYSICAL AND CHEMICAL PROPERTIES
Appearance:
Odor:
Solubility:
pH:
Melting range:
Vapor density:
Vapor pressure:
Relative density:
Evaporation rate:
Initial Boiling point, boiling range:
Flammability:
Partition coefficient:
Auto-ignition temperature:
Decomposition temperature:
Flash point:
Flammable limits:
10. STABILITY AND REACTIVITY
Reactivity :
Chemical stability:
Possibility of hazardous
White to off-white powder or granules
Odorless
Soluble in water
6-8
No data
N/A
N/A
2.4 to 2.6 g/cm 3 , depending on formulation
N/A
N/A
N/A
N/A
N/A
No data, decomposes by heating
N/A
N/A
Stable under normal conditions. Hygroscopic -absorbs
moisture from air, affecting product quality. Possible
decomposition at high temperatures.
Stable under normal conditions.
Stable. Spontaneous hazardous chemical
KB-1 I siremlab.com
PRIMER
l
I
reactions:
Conditions to avoid:
Incompatible materials:
Hazardous decomposition
products:
Shock sensitivity:
11. TOXICOLOGICAL INFORMATION
Rev. No.: 0
Date: 8 March 2016
Page: 5 of7
reactions/decomposition will not occur. Hygroscopic -absorbs
moisture from air, affecting product quality. Reacts with acids,
bases, oxidizing agents, chlorine trifluoride, magnesium, metals,
carbon, calcium oxide.
Incompatibles, may be sensitive to light and moist air.
Strong oxidizing agents, bases.
Carbon monoxide, carbon dioxide, nitrogen oxides, sulfur
oxides, potassium oxides.
Not shock sensitive; will not decompose and form shock
sensitive compounds.
The toxicological properties of this product have not been thoroughly investigated.
Amino Potassium Sodium
Acid Bicarbonate Sulfite
Toxicity: LD50 (Oral-Rat)(mg/kg): 1890 2064 2610-3560
LD50 (IV-Rat)(mg/kg): 1140 No data No data
LD50 (Oral-Mouse)(mg/kg): 660 No data No data
LC50 (I nhalation-Rat)(mg/m 3) No data >4880 >5500
LD50 (Dermal-Rat)(mg/kg) No data No data >2000
Carcinogenicity: NTP: No component of this product is identified as a
IARC: probable, possible or confirmed human
OSHA Z List
carcinogen.
OSHA Reg:
Teratogenicity: Not established -the chemical structures of
Mutagenicity: components do not suggest a specific alert for
these effects.
Reproductive:
Respiratory or skin sensitization: Not established
Specific target organ toxicity: Respiratory, skin, eye irritant, bladder, kidney
Effects of overexposure: Irritation, itching, gastrointestinal upset,
respiratory discomfort, blurred vision.
Medical conditions aggravated by exposure Chronic lung conditions, dry eye
Routes of entry: Ingestion, inhalation of dust, skin and eye
contact.
KB-I I siremlab.com
PRIMER
12. ECOLOGICAL INFORMATION
Ecotoxicity:
Persistence and
degradability:
Bioaccumulative potential:
Mobility in soil:
13. DISPOSAL CONSIDERATION
Rev. No.: O
Date: 8 March 2016
Page: 6 of 7
Components of this product are not considered to exhibit
significant ecological risks.
Amino acid is not persistent in the environment; will readily
degrade in the environment via biodegradation. Sodium sulfite
and potassium bicarbonate are inorganic products not subject
to biodegradation, but will degrade via other chemical
processes and are thus not persistent in the environment.
Significant accumulation in organisms is not expected.
Soluble in water, high mobility in soil.
Waste Disposal: Dispose in accordance with all applicable federal, state, and local environmental
regulations.
Container Disposal: Dispose in accordance with all applicable federal, state, and local environmental
regulations.
14. TRANSPORT INFORMATION
Domestic
(D.O.T.):
International:
IMDG:
IATA:
Proper Shipping Name:
Hazard Class:
UN/NA:
Labels:
Proper Shipping Name:
Hazard Class:
UN/NA:
Labels:
Proper Shipping Name:
Hazard Class:
UN/NA:
Labels:
15. REGULATORY INFORMATION
TSCA:
SARA TITLE Ill
Section 302 (EHS) Ingredients:
Section 313 Ingredients:
Section 304 (EHS/CERCLA) Ingredients:
CHEMICALS, N.O.S. (NON-REGULATED)
Not applicable
Not applicable
Not applicable
CHEMICALS, N.O.S. (NON-REGULATED)
Not applicable
Not applicable
Not applicable
CHEMICALS, N.O.S. (NON-REGULATED)
Not applicable
Not applicable
Not applicable
Yes
No
No
No
SARA TITLE Ill NOTIFICATION INFORMATION
Acute Health Hazard: No
KB-I siremlab.com
PRil\lER
l
I
l
\
l
Chronic Health Hazard:
Fire Hazard:
Sudden Release of Pressure Hazard:
16. OTHER INFORMATION
No
No
No
Rev . No .: 0
Date: 8 March 2016
Page: 7 of?
SiREM provides the information contained herein for hazard communication and safety planning
purposes, based on existing information on each of the product components available in the literature; no
independent testing was conducted on the final product. The above information is intended to be used
only as a guide to the appropriate precautionary handling of this material by a properly trained person.
KB-I I siremlab.com
PRIMER
Material Safety Data Sheet
Nutrimens® - Liquid
Bioremediation Nutrient
to rsus
enviYemenenta!
[-Section 1: Chemical Product and Company Identification
Product Name: Yeast Fermentation Product
Catalog Codes: Nutrimens' Liquid
CAS#:
TSCA: NA
HMIS Code: NA
Trade Name and Synonyms: Nutrimens -
Liquid
Chemical Family: Yeast Fermentation Product
Contact Information:
Tersus Environmental, LLC
109 E. 17th Street, Suite #3880
Cheyenne, WY 82001
Ph- 307.638.2822 - info [e-mail]
www.tersusenv.com
For emergency assistance, call: 919.638.7892
[Section 2: Composition and Information on Ingredients
COMPONANT
OSHA OSHA
CAS # TWA STEL
No known hazardous
ingredients present.
ACGIH ACG1H
TWA STEL
HAZARDOUS INGREDIENTS: NONE AS DEFINED UNDER THE U.S. OSHA HAZARD
COMMUNICATION STANDARD (29 CFR 1910.1200) OR THE CANADIAN HAZARDOUS PRODUCTS.
ACT S.C. 1987, C.30 (PART 1).
SARA HAZARD: NONE NOTED (SECTION 311/312) TITLE III SECTION 313 - NOT LISTED
All components of this product are listed on the TSCA registry.
TSection 3: Physical/Chemical Characteristics
Boiling Point 212 degrees F
Vapor Pressure (mmg Hg) N/A
Vapor Density (AIR = 1) N/A
Solubility in Water dispersible
Appearance and Odor brown viscous liquid. yeast aroma
Specific Gravity (H2O = 1) N/A
Metting Point. N/A
Evaporation Rate N/A
(Butyl Acetate = 1)
Section 4: Fire and Explosion Data
FLASH POINT (METHOD USED) N/A
FLAMMABLE LIMITS N/A
LEL N/A
UEL N/A
EXTINGUISHING MEDIA none
SPECIAL FIRE FIGHTING PROCEDURES none
fVlateriai Safety Data Sheet May 11, 2011
Rage 1 Rev t7ate: April 14, 2014

Material Safety Data Sheet
UNUSUAL FIRE FIGHTING HAZARDS none
t�YSiAS
nvronnuAr�
Section 5: Reactivity Data
STABILITY: Generally stable.
HAZARDOUS POLYMERIZATION: Will not occur.
Section 5: Health Hazard Data
Based on specific concentration as sold
ROUTE(S) OF ENTRY- inhalation
HEALTH HAZARDS (ACUTE AND CHRONIC) Respiring yeast generates carbon dioxide.
Over exposure to carbon dioxide gas may cause asphyxiation.
CARCINOGENICITY' No
NPT No
OSHA REGULATED No
SIGNS AND SYMPTIONS OF EXPOSURE .... Over exposure to carbon dioxide include.
stupor. dizziness, unconsciousness, death.
MEDICAL CONDITIONS GENERALLY AGGRAVATED
BY EXPOSURE None known for this product. Over exposure to
carbon dioxide may aggravate certain medical conditions.
EMERGENCY AND FIRST AID PROCEDURES ................ If exposed to carbon dioxide, move to fresh
air. Give respiratory support if needed. Seek medical attention.
Section 7: Precautions for Safe Handling and Use
STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED: Conventional cleanup
WASTE DISPOSAL METHOD: In accordance with Federal, State and Local regulations
PRECAUTIONS TO BE TAKEN IN HANDLING AND STORING' Store in a cool area.
OTHER PRECAUTIONS None
Section 8: Control Measures
RESPIRATORY PROTECTION (SPECIFY TYPE): Confined spaces that held yeast fermentation product
could potentially contain carbon dioxide gas. Use NIOSH/MSHA approved self-contained breathing
apparatus or supplied respirator if oxygen content below 19%. Use in accordance with 29 CFR 1901,134
IS RESPIRATORY PROTECTION NECESSARY: UNNECESSARY IF VENTILATION IDENTIFIED
BELOW IS USED
VENTILATION LOCAL EXHAUST: Use adequate mechanical ventilation.
Material Safety Data Sheet May 11, 2011
Page 2 Rev Date: April 14, 2014

Material Safety Data Sheet
PROTECTIVE GLOVES: Work Type
EYE PROTECTION: Safety glasses a good practice
OTHER PROTECTIVE CLOTHING OR EQUIPMENT: None
HYGENIC PRACTICES: Good manufacturing practices
PROTECTIVE CLOTHING UNNECESSARY IF OTHER CONTROL MEASURES ARE USED
tarsus
..virwoxental
1 Section 9: Disclaimer and/or Comments
We suggest that containers be either professionally reconditioned for re -use by certified firms or properly
disposed of by certified firms to help reduce the possibility of an accident. Disposal of containers should
be in accordance with applicable federal. state and local laws and regulations. "Empty" drums should not
be given to individuals.
The conditions of handling, storage, use and disposal of the product are beyond our control and may be
beyond our knowledge. For this and other reasons, we do not assume responsibility and expressly
disclaim liability for loss, damage or expense arising out of or in any way connected with the handling,
storage, use or disposal of the product.
The information above is believed to be accurate and represents the best information currently available
to us. However, we make no warranty of merchantability or any other warranty, express or implied, with
respect to such information, and we assume no liability resulting from its use. Users should make their
own investigations to determine the suitability of the information for their particular purposes. In no event
shall Tersus Environmental be liable for any claims, losses, or damages of any third party or for lost
profits or any special, indirect, incidental, consequential or exemplary damages, howsoever arising, even
if Tersus Environmental has been advised of the possibility of such damages.
Nutrimens° is a registered trademark Tersus Environmental, LLC.
Material Safety Data Sheet May 11, 2011
Page 3 Rev Date- April 14. 2014

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MW-46
iSCALE: 1"= 60' Vat.
EW-6
INJECTION
LOCATION
DOWNGRADIENT
20'
7' SIDEGRADIENT
PROPOSED
MONITORING
WELL (TYP.)
LEGEND
— SITE BOUNDARY
• SHALLOW MONITORING WELL
• REMEDIATION SYSTEM EXTRACTION WELL
• SHALLOW MONITORING WELL - STATUS UNKNOWN
544 90 GROUNDWATER ELEVATION (ft AMSL)
570-- GROUNDWATER ELEVATION CONTOUR (ft AMSL)
(DASHED WHERE INFERED)
DIRECTION OF GROUNDWATER FLOW
NOTE: *WELL NOT USED IN GROUNDWATER ELEVATION
INTERPRETATION.
250 0 250
SCALE IN FEET
1"=250'
N
1
cn
LL

Table 1
Injection and Monitoring Well Construction
Former Rental Towel Uniform Services Facility
610 Woody Drive, Graham, North Carolina
Well ID
Existing Monitoring/Injection Well
EW-6
Proposed Pilot Test Monitoring Wells
PMW-1
PMW-2
PMW-3
Notes
PVC-Polyvinyl chloride
ft-feet
bgs-below ground surface
I Well I I I Screened I Sand Diameter Well Interval Interval (ft
(inches) Material Well Type (ft bgs) bgs)
6 PVC Permanent 11-31 9-31
2 PVC Permanent 21-31 19-31
2 PVC Permanent 21-31 19-31
2 PVC Permanent 21-31 19-31
Well Contractor: South Atlantic Environmental Drilling and Construction Company (Certification Number 3351)
Bentonite
Seal (ft Grout (ft
bgs) bgs) Grout Type
7-9 0-7 Portland Cement
17-19 0-17 Portland Cement
17-19 0-17 Portland Cement
17-19 0-17 Portland Cement
Table 2
Proposed Pilot Study Performance Monitoring Plan
Former Rental Towel Uniform Services Facility
610 Woody Drive, Graham, North Carolina
Monitoring Program
Existing Monitoring/Injection Weil
Well Diameter
(inches)
Well Construction
Screened
interval
(ft bgsl Field TOC VOC EA MA DHB Field TOC VOC EA MA DHB Field TOC VOC EA MA DHB Field TOC VOC EA MA DHB
Baseline
Month 1
Month 2
Month 3
DHC!
DHCI
DHCI
DHCI
EW-6
6
PVC
11-31
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
Proposed Pilot Test Monitoring Wells
PMW-1
rPMW-2
PMW-3
2
2
2
PVC
PVC
PVC
21-31
21-31
21-31
Notes
Field = Field Parameters - DTW, D0. pH. ORP, temperature, conductivity
TOC = Total Organic Carbon (EPA 415.1)
VOC = Volatile Organic Compounds (EPA 82608)
EA = Electron Acceptors/Degradation Products: sulfate (EPA 375.3/300), ferric iron (EPA 6010), ferrous iron )EPA 6010). inorganic
carbon (9060A). carbon dioxide (MOD EPA 38101, ethene (MOD EPA 3810). ethane (MOD EPA 3810), methane (MOD EPA 3810)
MA = Metabolic Acids (AM21 0)
DHC = ❑ehalococcaides sp
DNB = Dehalobacter sp.
PMW- Proposed Monitoring Weil
IW- Injection Well
55 - stainless steel
PVC - Polyvinyl Chloride
DTW - depth to water
DO - dissolved oxygen
ORP - Oxidation Reduction Potential
EPA - Environmenial Protection Agency
bgs - below ground surface
The proposed monitoring schedule is subject to change. Additions and/or deletions to the proposed monitoring plan are expected
1 1 1
1 1 1
1 1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1 1
1 1 1
1 1 1
1
1
1
1
1
1 1
1
1
1 1
1
1
1
1
AECOM
Page 1 of 2

Table 2
Proposed Pilot Study Performance Monitoring Plan
Former Rental Towel Uniform Services Facility
610 Woody Drive, Graham, North Carolina
Monitoring Program
Existing Monitoring/Injection Well
EW-6
Well Diameter
inches
Proposed Pilot Test MonitorinaWells
Well Construction
6 PVC
Screened
Interval
ft b. s) Field TOC VOC EA MA I]HB Field TQC VOC EA MA DIAB Field TOC VOC EA MA DI-I8
Month G
Month 9
11-31
PMW-1 2 PVC 21-31
PMW-2 2 PVC 21-31
PMW-3 2 PVC 21-31
1
1 1
1
1
1
DHCI
1
DHCf
1 I_ 1 j 1 I 1
1 1 1 1
1 1 1 1
1 1 1 1
Month 12
1 1 1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
DHCI
1
Notes
Field = Field Parameters- DTW, ❑O, pH, ORP, temperature, conductivity
TOC = Total Organic Carbon (EPA 415.1)
VOC = Volatile Organic Compounds (EPA 82808)
EA = Electron Acceptors/Degradation Products- sulfate (EPA 375.3/300), ferric iron (EPA 6010), ferrous iron (EPA 6010). inorganic
carbon (9060A), carbon dioxide (MOD EPA 3810), ethene (MOD EPA 3810). ethane (MOD EPA 3310), methane (MOD EPA 3310)
MA = Metabolic Acids (AM21G)
DHC = Dehalococcoides sp.
DNB = Dehaiobacter sp.
PMW- Proposed Monitoring Well
IW Injection Well
SS - stainless steel
PVC - Polyvinyl Chloride
❑TW - depth to water
DO - dissolved oxygen
ORP - Oxidation Reduction Potential
EPA - Environmental Protection Agency
bgs - below ground surface
The proposed monitoring schedule is subject to change. Additions and/or deletions to the proposed monitoring plan are expected.
AECOM
Page 2 of 2